The Mediating Role of Psychological Distress on the Effect of Self-Efficacy to Academic Resilience of Emerging Adults: Implications for CBT Intervention

doi:10.21203/rs.3.rs-3240210/v1

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The Mediating Role of Psychological Distress on the Effect of Self-Efficacy to Academic Resilience of Emerging Adults: Implications for CBT Intervention

https://doi.org/10.21203/rs.3.rs-3240210/v1

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The COVID-19 pandemic has affected many individuals' mental health, including emerging adults. Changes in the environment and the mode of education made students vulnerable to psychological distress. However, there has been little empirical research on psychological distress, academic resilience, and self-efficacy. The study sought to determine the mediating role of psychological distress in the effect of self-efficacy on academic resilience—350 Filipino emerging adults recruited from various Metro Manila colleges and universities. Multi-aspect questionnaires were utilized to assess psychological distress, self-efficacy, and academic resilience. Structural equation modeling was used to explain the relationships, mediation, and causality and test the hypothesized model. SEM revealed that psychological distress mediates self-efficacy and academic resilience; higher self-efficacy leads to higher academic resilience; higher psychological distress leads to lower academic resilience, and higher self-efficacy leads to lower psychological distress. The study's findings have implications for a Cognitive-Behavioral Therapy Intervention for psychologically distressed students. A proposed individual intervention is recommended for implementation, which mental health practitioners can use to address the variables of the study.

Biological sciences/Psychology/Human behaviour

Health sciences/Signs and symptoms

Academic Resilience

Emerging Adulthood

Psychological Distress

Self-Efficacy

The developmental period of adolescence plays an important role in an individual’s growth as emotional, physical, and cognitive changes occur during this phase. This suggests that adolescents must be in formal education as part of their normal development. However, the world is under a global pandemic caused by a recently discovered coronavirus strain since its outbreak in Wuhan, China, in December 2019. COVID-19 is an infectious disease that is spread from one person to another that causes symptoms such as fever, dry cough, tiredness, aches and pains, sore throat, and diarrhea. As of writing, there are around 649 million confirmed cases of COVID-19 worldwide with about 6.65 million deaths according to the World Health Organization^[42]. This has resulted in the community quarantine of affected countries, including the Philippines, which is reported to have more than 4.03 million confirmed cases of the virus, with around 64,571 deaths. As a result, the entire country has been placed under community quarantine beginning 17 March 2020. The preventive measures of the Philippine government to stop the spread of the virus include the imposition of strict home quarantine, restrictions on gatherings, and alternative work settings for employees.

According to the World Health Organization (WHO), although older people and those with an underlying medical condition are most vulnerable to contracting the virus, there are still reports of COVID-19 cases in children and adolescents worldwide. Hence, the Department of Education (DepEd) adopted blended learning to continue education under the new normal^[29]. The alternative learning set-up includes a shift to online classes instead of face-to-face school activities and offline tools such as modules provided by DepEd. With this, conducting face-to-face courses has also been prohibited during the first months of imposed community quarantine. However, as the global pandemic eases, restrictions and the alert level in the country have been downgraded, allowing a transition of the educational system to adopt the Hybrid-Flexible (HyFlex) learning mode that combines face-to-face and virtual classes.

The global pandemic has affected people's livelihood, physical and psychological health. As virus prevention protocols were imposed, the mental health condition of the affected community has also been considered the top priority^[43]. Psychological distress such as anxiety and depression were among the common concerns experienced by many during the transition. It flustered many individuals, especially during the first month of the outbreak. In terms of the educational system, classes have been conducted online since March 2020 and continued with Blended learning, a combination of classroom activities and academic sessions via virtual set-up^[26]. Because of the rapid transition, Filipino adolescents reported higher levels of stress and anxiety, and depression during the pandemic's first months^[40].

As of writing, the country has seen more lenient restrictions in terms of interactions as months go by. This resulted in mandatory in-person classes to push through, wherein all schools were required to switch to in-person instruction starting on November 2, 2023, and using physical distancing whenever possible, as instructed by the Vice President and Education Secretary Sara Z. Duterte^[31].

The student's psychological well-being underwent numerous changes as a result of this radical change, including the new learning style that brought harder academic assignments, heavier coursework, and other related changes. The literature of this study explained that during the second year of the pandemic, students have made several adjustments and that there were differences among the factors that contributed to their level of psychological distress now and those they experienced then. In other words, the students have already adjusted to the virtual learning mode, and have also developed a greater propensity for psychological distress.

Some significant changes experienced by college students result in a wide range of distress, such as changes in sleeping patterns, and diet, and difficulty managing them due to increased stress levels^[33],[6]. Even before the pandemic, the link between academic stress and depression was a major source of concern for many people^[24]. In another study among Chinese undergraduate students, 20 to 40% reported having depression or anxiety as a common psychological distress^[22]. University students in China are said to have also gone through psychological distress compared to the pandemic period, which manifested as increased virus fear^[39]. Similarly, anxiety aggravates college students' personal problems. In addition, low self-efficacy is linked to fewer help-seeking behaviors in students, especially in counseling^[30]. High academic self-efficacy raises academic achievement and may lessen a student's vulnerability to depression^[28],[5].

According to the Department of Health (DOH) and the Philippine Pediatric Society (PPS), the late adolescence period includes ages 17–19^[12]. The period between adolescence and adulthood is referred to as Emerging adulthood, defined by developmental psychologist Jeffrey Jensen Arnett in 2000 ^[3]. Individuals at this stage are from 18 to 22 and beyond and are referred to as emerging adults. The present study classifies them as ‘emerging adult college students’ to fit the profile of the respondents.

Educators were entrusted with the primary responsibility of teaching academic courses and addressing the students’ psychological health concerns related to academics^[8]. Essentially, counseling programs and interventions for the mental health of students are implemented in different colleges and universities which were headed by school administrators, guidance counselors, and other psychology professionals to help address the common issues concerning the emotional, psychological, and vocational development of students ^[41],[30]. Although the said programs were already in place, research showed an immense need for more implementation of counseling programs that would emphasize the prevalent psychological concerns of students relative to their development as students^[16].Thus, the outcome of the present study provided implications for psychological intervention to aid tailored guidance to universities/college institutions in terms of counseling and other related interventions in school.

The present study utilized the framework of The Stress Process in explaining the psychological vulnerability of students to psychological distress, along with the Self-Efficacy Theory, in elucidating the beliefs of emerging adult college students relative to their academic concerns. In addition to the framework of the study, the Challenge Model of Resilience further supports the respondents’ academic resilience.

The present study explored the mediating role of psychological distress on the causal relationship between self-efficacy and academic resilience. More importantly, the findings of this research were limited to exploring results incurred only within the data-gathering period and providing implications for program development in addressing students' psychological distress through the concepts of Cognitive-Behavioral Therapy Intervention. Identifying other factors affecting students' mental health, as presented in the study's outcome, is beyond its scope but was noted for future recommendations.

Due to academic-related demands brought by the changes from the shift of mode of learning, some college students have manifested psychological distress such as anxiety and depression. Some students overcome adversities easily with their natural coping strategies through self-efficacy, and others may struggle to overcome these stressors ^[27],[6]. Consequently, academic resilience is affected when students are psychologically distressed. Students under psychological distress refrain from seeking help from a professional despite the availability of mental health services^[15].

Despite local studies providing an overview of students' mental health, the return to traditional classroom instruction has raised more questions about the student's academic resilience as they return to the standard education setup. Moreover, there was limited research on strengthening emerging adult college students in the school setting to improve resilience and develop new coping strategies to meet the challenges encountered^[23]. Changes in the mode of learning from the virtual setup to the Hyflex mode suggest a gradual recovery of the educational system. In addition, with less help-seeking behavior, a strong need is seen to strengthen mental health programs intended for students that will be beneficial for their academic journey and later endeavors and psychology, guidance, and counseling ^[37],[16]. Therefore, the present study provided implications for psychological intervention to raise awareness of mental health services and that the availability of support will help them address academic problems effectively and encourage them to engage in more help-seeking behaviors.

Research Impediments

The present study involved selected emerging adult college students from comprehensive universities. The current situation in the global pandemic allowed the Hyflex approach of learning to be implemented in schools and universities. The data-gathering procedure of the study utilized online platforms for test administrations.

Some parts of the data-gathering procedure may trigger a disturbance in the respondents’ emotions, including anxiety, trauma flashbacks, or other strong negative feelings that may affect their disposition during the said process. To attend to these concerns, the researcher and a psychologist offered an immediate debriefing to psychologically distressed students. Information about the debriefing was included and discussed in the consent form before data gathering.

Significance of the Study

This study examined the mediating role of psychological distress in the causal relationship between self-efficacy and academic resilience among emerging college students and provides implications for program development. The outcome of this research is beneficial to the following:

For emerging adult college students

The variables presented in the study are all relative to the student's academic journey. This research is most beneficial to the students by informing them of the accessibility of mental health services at schools, improving their help-seeking behaviors, and eventually reducing the stigma associated with psychological conditions. More importantly, students' mental health is essential, after all. This research helps enlighten that everyone may experience psychological distress due to numerous factors, including academic concerns and that schools are safe places for students to seek help with mental health concerns associated with their academic journey, with professionals willing to help them address and improve their psychological health.

For school administrators and guidance counselors

The findings of this study provided implications for psychological intervention intended to address the mental health of psychologically distressed students. School administrators and guidance counselors can improve their existing counseling programs to further enhance students' academic resilience and self-efficacy, even when faced with adversity. Teachers also benefit from the outcome of this study as they can directly discern the students' unique learning strategies observed in the classroom and the mental health challenges students might experience.

For clinical psychologists

Clinical psychologists and mental health practitioners are the key experts in improving existing programs and developing new interventions for emerging adult college students' mental health. Looking into the targeted variables of the study relative to the student's academic journey is incredibly beneficial in the clinical assessment and counseling of students with educational and mental health problems as it provides tailored psychological guidance. More importantly, experts would help raise awareness of the psychological distress experienced by students and would then be used in future references to promote mental health.

For future researchers

This study is advantageous for researchers who intend to practice in educational and clinical settings and those who study academic development. It also contributes to the literature on the variables of the study. It would open more opportunities for researchers to look into the unique individual experiences of students in their academic journey, allowing them to explore more factors affecting educational development.

THEORETICAL FRAMEWORK

Three theoretical models guided the present study: The Stress Process pioneered by Leonard Pearlin to explain psychological distress, the Self-Efficacy Theory by Albert Bandura for self-efficacy, and the Challenge Model of Resilience by Michael Rutter to explain academic resilience further.

The Stress Process

Leonard Pearlin introduced the Stress Process in 1981 through a model wherein stress includes life events and chronic stressors, resources as social and personal associated with coping, and depressive symptoms as a mental health factor. This model presents a "system of causal relationships" that explores the stressor's effect on the individual's mental health ^[2]. The model aims to explain the direct effects of the factors (life events and chronic stressors) on the individual's mental health. Leonard Pearlin pioneered the Stress Process Model in a sociological stance, seeing problems encountered by an individual continue to arise from life events that may be associated with chronic stressors. Hence, these circumstances harm an individual's mental health, wherein the present study describes psychological distress. Accordingly, the relationship between the stressors and mental health effects was mediated by personal and social factors such as social support, mastery, self-esteem, and coping mechanisms in favor of favorable comparisons and devaluation of money. Individual and societal roles were substantially affected, negatively impacting their mental health, more specifically, making them vulnerable to psychological distress. The present study discussed that academic-related stress and other factors may have influenced college students to be vulnerable to experiencing psychological distress, such as anxiety and depression, and impact their self-efficacy and academic resilience. The Stress Process allowed the researchers to explain how the stressors affect emerging adults' mental health. This framework is essential in identifying specific stressors of the targeted respondents relative to academic concerns by exploring the stress process and its effect on their mental health.

Self-Efficacy Theory

The present study adopts the concept of Self-efficacy from Albert Bandura's Social Cognitive Theory. The concept of human agency, as having the exercise of control over our beliefs and behavior, enfolded self-efficacy as a construct. Self-efficacy was defined as the individuals' perceived capabilities to attain designated types of performances and achieve specific results ^[5] and underlined the value of learning opportunities within certain domains in which people assess their level of self-efficacy successfully operating. Moreover, it states that a person's physiological or emotional arousal level affects their performance of particular tasks and choices.

This theory outlines various ways or judgments that an individual can use to develop self-efficacy:

Through vicarious experience, people can gain high or low self-efficacy by watching others perform and comparing their competence to that of the other person;

They encouraged a person or their ability to perform influences self-efficacy through Social and Verbal Persuasion;

Physiological Feedback influences an individual's individual beliefs of efficacy when experiencing sensations from their body, as well as how they perceive this emotional arousal.

These self-efficacy judgments outline the significant impact to an individual's behavior outcome^[5]. Where he discussed the following assumptions related to self-efficacy: (a) outcomes were most likely to be successful when efficacy is high, and the environment is responsive; (b) When people with high efficacy encounter unresponsive environmental situations, they usually intensify their efforts to change the environment; (c) when low efficacy is combined with a responsive environment, people may become depressed when they see others succeeding at a task that appears too difficult for them; (d) when low self-efficacy combines with an unresponsive environment, people were likely to feel apathy, resignation, and helplessness. Therefore highlighting, people’s belief in their efficacy influences the courses of action they choose to pursue, how much effort they invest in activities, how long they persevere in the face of obstacles and failure experiences, and their resilience following setbacks.

The Challenge Model of Resilience

Research on resilience generally defines it as a response to a stressor or adversity. Three general models were classified to explain the impact of these stressors on a person's psychological well-being and how resilience protects that impact. Michael Rutter introduced the Compensatory Model, the Protective Model, and the challenge model in 1987^[31]. These models explain how promotive factors (positive contextual, social, and individual variables) that influence the resilience process help adolescents overcome the impact of risk exposure to adversity^[44]. At the same time, the Compensatory Model focuses on the resilient characteristics that decrease the amount of stress an individual experiences. The promotive factors in this model play a significant role in predicting an outcome of the factors, therefore neutralizing the risk of adverse outcomes. On the other hand, the Protective Factor Model considers resilience as factors that support the entire process (a person's recovery from adversity). This Model suggests that promotive factors may operate to moderate or reduce the association between risks and adverse outcomes and to enhance the effects of either promotive factor alone for predicting an outcome.

When applied to academic research about youth development, the resilience theory stresses some essential points on the risk exposure of students and focuses on adaptation and understanding healthy development^[13]. Since resilience focuses on overcoming adversities, perhaps, the challenge model supports the present study’s framework in explaining adolescent academic resilience. This model addresses the adaptation phase of resilience and that when a challenge, provided it is not too extreme, can enhance a person’s ability to adapt to adversity can prepare them for the next challenge. Additionally, the process of resilience, as emphasized in this model, allows emerging adults vulnerable to adverse outcomes due to moderate exposure to risk to adapt through resilience^[12]. In the respondents of the present study, the hypothesized model illustrates that the students have become vulnerable to psychological distress due to numerous factors that have influenced their self-efficacy and academic resilience. Among the resilience models, the challenge model has the most applicable concepts relative to youth academic resilience, primarily focusing on the process and adaptation to adversity. As stated in this framework, resilience happens when they overcome adverse outcomes and prepare for them the next adversity. Thus, a student may remain resilient despite low self-efficacy or a moderate level of psychological distress.

Figure 1 below shows the hypothesized model depicting the mediating role of the variables presented in the study namely psychological distress, self-efficacy and academic resilience.

The Hypothesized Model

H1 High self-efficacy leads to better academic resilience.

H2 High self-efficacy leads to lower psychological distress.

H3 More psychological distress leads to lower academic resilience

H4 Psychological distress mediates the causal relationship between self-efficacy and academic resilience.

The present study used a quantitative research design to analyze multiple relationships of the variables. To implement the predictive correlational design, Structural Equation Modelling (SEM) was used. SEM is a statistical technique that examines multiple relationships to test the mediation model and determine whether it fits the observed data^[27]. SEM is composed of the measurement model and the structural model. A measurement model measures the latent or composite variables and ensures the factors and indicators have correct measures and good factor loading. On the other hand, a structural model tests all the hypothetical dependencies based on path analysis^[15]. The structural model was created based on the measurement model to estimate the relationships between the measured constructs of academic resilience, psychological distress, and self-efficacy. Moreover, it answered the research questions to test the present study's hypothesis.

Subject and Study Sites

Respondents of the study involved 350 selected undergraduate students recruited from comprehensive universities around Metro Manila. The study used a purposive sampling method in which the respondents were screened following inclusion and exclusion criteria. The snowball technique, which involves choosing samples from subjects utilizing referral chains who share common characteristics of study interest, was used to collect responses^[19]. Through referrals, college professors, college counselors, and emerging adults at schools were able to enlist more respondents.

Most respondents were 56.6% female, while 41.7% were male. In terms of year level, most were first-year students, who comprise 34.9% and 26% were fourth-year students. In terms of age, the average number of respondents who participated is 20, which falls under the emerging adult college students’ criteria. The respondents aged 18 to 22 and beyond classify as students in the emerging adulthood developmental stage. The respondents were chosen according to the following criteria: (a) age = 18 to 22 years old; (b) Filipino citizen, (c) enrolled in any program offered by their school, (d) year level = first to fourth-year level. The exclusion criteria involve respondents with a previous or existing psychological/psychiatric condition diagnosis, such as anxiety or depression, who could still participate in the study. It was also noted that most respondents were enrolled in Engineering and Architecture courses (48.91%) and Behavioral Science courses (31.4%). Among the respondents enrolled in a college/university in Metro Manila, most of them were from Colegio de Muntinlupa (51.1%), Bulacan State University (18.3%), and the University of Santo Tomas (4.9%). Regarding the need for immediate debriefing, most respondents did not need an immediate psychological debriefing (82%). In comparison, a few respondents (18%) agreed they needed an immediate psychological debriefing but opted not to proceed. Of the 18% who agreed to be debriefed, no one offered the service.

Research Instruments

Academic Resilience Scale (ARS-25) Dr. Simon Cassidy developed the Academic Resilience Scale-30 (ARS-30) in 2016 which consists of a five-point Likert scale that can be answered from (1) 'likely' to (5) 'unlikely'. Developing a context-specific construct measure of academic resilience based on students' responses to academic adversity was the goal behind the ARS-30^[7].The author further states that the items on the scale measure the academic concept of psychological resilience^[9].

ARS-30 consists of 30 items with three-dimensional factors: (1) Perseverance includes items referring to "hard work, not giving up, sticking to plans and goals, accepting and utilizing feedback, imaginative problem solving, and treating adversity as an opportunity to meet challenges and improve"; (2) Reflecting & Adapting Help-Seeking items reflecting on "strengths and weakness, altering approaches to study, seeking help, support and encouragement, monitoring effort and achievements and administering rewards and punishments"; and (3) Negative Affect & Emotional Response includes themes of "anxiety, catastrophizing, avoiding negative emotional responses, optimism, and hopelessness"^[7]. The total score was achieved by summing scores for all 30 items after reverse-scoring selected items, followed by factor scoring by summing item scores containing three-dimensional factors of the scale.

The scale has shown high internal reliability with a Cronbach’s Alpha of 0.90 and high concurrent validity. It reported a significant positive correlation between ARS-30 scores and academic self-efficacy (r = 0.49), The pilot test in the current study produced a consistent result of 0.83 for the Perseverance factor, 0.78 for the Reflective & Adaptive Help-Seeking factor, and 0.80 for Negative Affect & Emotional Response factor, which indicated high reliability.

Kessler Psychological Distress Scale (K-10 ) is a widely used self-report instrument to screen emotional states characterized by the anxiety-depression spectrum to identify an individual's psychological distress level. Professor Ronald C. Kessler developed the checklist at Harvard University in 1992. K-10 is composed of 10 questions about emotional states. The items were answered on a five-point Likert scale with rates ranging from (1) "None of the time," (2) "A little of the time," (3) "Some of the time," (4) "Most of the time," to (5) "All of the time" respectively. Scores on each dimension were calculated by getting the sum of all item responses, yielding a minimum score of 10 and a maximum score of 50, indicating low or high psychological distress levels.

The principal author of the test and other researchers used the joint health and well-being survey to determine the reliability of the test, which showed an average reliability score of 0.74^[17]. On the other hand, in an analysis of the K10 on a Brazilian sample, the test is a reliable measure of psychological distress with an excellent Cronbach's Alpha of 0.93^[35]. The pilot test in the current study produced a consistent result of 0.88, which indicates that K10 items demonstrated high reliability. This shows that the test is a reliable source for screening psychological distress.

General Self-Efficacy Scale (GSE) Matthias Jerusalem and Ralf Schwarzer created the General Efficacy Scale (GASE) in Berlin, Germany, in 1992 to determine individuals' general self-efficacy in certain stressful situations^[36]. This instrument consists of ten items rated on a four-point Likert-type scale ranging from 1 (not at all true about me) to 4 (very true about me). Items of the scale consist of features of individuals' successful coping themes, namely Emotional Response, Depression, Anxiety, and Stress Management. A total score is calculated by summing up the item responses.

The total score ranges between 10 and 40. A high score on this test suggests more self-efficacy. The pilot test in the current study produced a Cronbach Alpha 0.76, which indicates the high reliability of GSE items. In terms of the validity of the test, The GSE is positively correlated to "emotion, optimism, work satisfaction, and negative coefficients were found for depression, stress, health complaints, burnout, and anxiety"^[52].

Data Gathering Procedure

The present study investigated the mediating role of psychological distress in the causal relationship between self-efficacy and academic resilience of emerging adult college students. The researchers ensured that the data collected from the study was confidential to ensure safety, privacy, anonymity, and the respondents’ information. The data-gathering procedure began with an extensive review of related literature on the study's variables. Respondents were invited via online platforms, and their informed consent was obtained. The informed consent forms and test questionnaires were converted to Google Forms and administered through the same platform. The researchers were given permission by the test authors to conduct the tests online. The respondents accomplished three quantitative measures: (1) Kessler Psychological Distress Scale (K-10); (2) General Self-Efficacy Scale (GSE); and (3) Academic Resilience Scale (AR-10). Respondents were provided a link to access the tests before answering them. Responses were collected as soon as they accomplished the tests and submitted all forms. A copy of the completed forms and their responses were provided to their email for personal copies. During the data-gathering procedure, the researcher offered an immediate virtual debriefing to psychologically distressed students, particularly those with negative emotions. They were provided a link they could access for the debriefing session. The researcher was prepared to conduct the debriefing through the Zoom application for the procedure. A licensed psychologist was ready to conduct the said procedure along with the researcher. A debriefing form was also created to guide the psychologist in facilitating the debriefing through the script provided.

Quantitative data was then encoded to the Statistical Package for the Social Sciences (SPSS) Version 28.01. Structural Equation Modelling was utilized to finally analyze the relationships, specifically through IBM AMOS SPSS Version 28.

Ethical Consideration

The Philippine Social Science Council's Social Science Ethics Review Board (SSERB) has approved all protocols used in the data collection process, and all methods used were carried out in accordance with the pertinent guidelines and regulations.

The respondents of the study were provided informed consent prior to data collection. The form includes detailed information about the study’s purpose, limitations, and technology used by the selected respondents. Tests were administered through the same online platform where the respondents have submitted their responses. After accomplishing the tests, respondents received a copy of their responses at their respective email addresses.

The content of the data-gathering procedure remains confidential. A data management plan was created to ensure the privacy and anonymity of the respondents, including the following:

Respondents indicated their year level and sex in the questionnaire, and options were given for them to indicate their names/nicknames or leave them black;

The data collected from the responses were stored digitally in a secured Google drive owned by the researcher and to be deleted from the drive and the computer six months after the data gathering and analysis is complete and;

The data collected were accessible only to the principal researcher and the statistician for data analysis. More importantly, to ensure that the personal data of the respondents were not compromised, a security password was set to give access only to those authorized.

Data Availability Statement

The datasets generated and/or analyzed during the current study are not publicly available due to security of data and privacy of the respondents but are available from the principal author (Nirvana Shiroi de Guzman Bania) on reasonable request.

The present study followed a dissemination plan as to how the findings were useful to the students, college institutions, the Commission on Higher Education (CHED), and other professional associations related to clinical psychology. They were informed of the results through publication or presentation at research conferences. The findings of this study greatly contributed to existing literature studies in clinical psychology, especially on research on the impact of the global pandemic on the educational setting. Furthermore, the findings emphasize its importance in program development suitable for guidance counselors and mental health practitioners. Some of the respondents manifested a significant level of psychological distress. The researchers protect this vulnerable group by providing a disclaimer on the informed consent before administering tests, which indicates that the test contains items that require their response related to their experiences, feelings, outlook, or perspectives that may trigger negative emotions associated with past or present events in their life. A debriefing script was prepared to guide the psychologist of the procedure, along with a debriefing form, containing a list of information on institutions that provide mental health access.

Data Analysis

Standardized psychological tests were used in the process for the targeted 350 respondents. Data collected from the respondents, such as demographics and test results from the quantitative measures, were carried out in the Statistical Package for the Social Sciences (SPSS) for statistical analyses. The means and standard deviations presented in Table 2 showed the level of academic resilience, self-efficacy, and psychological distress and were interpreted as a measure of centrality.

Structural equation modeling was utilized through the Analysis of a Moment Structure (AMOS) to explain the relationship and mediation analysis. In answering the succeeding research questions, a preliminary model test was conducted to test the structural model. Fit statistics included Root Mean Square Error of Approximation (RMSEA), Goodness-of-Fit Index (GFI), Normed Fit Index (NFI), and Comparative-of-fit Index (CFI) to indicate a good model fit.

The list of indicators, dimensions, variables, and factor loadings were shown in Table 1 below. Confirmatory factor analysis (CFA) was performed to establish that the factors of academic resilience, indicators of self-efficacy, and psychological distress measure the construct. CFA was required to test the pre-specified relationships and to test the appropriateness of the foreign-made standardized instruments to the respondents of the study.

Table 1

*List of Indicators, Dimensions, Variables, and Factor Loadings*
Indicators, Dimensions, Variables	Factor Loading	Cronbach Alpha
Academic Resilience		0.90
Factor 1: Perseverance	0.852
Factor 2: Reflecting & Adaptive Help-Seeking	0.781
Factor 3: Negative Affect & Emotional Response	0.696
Self-Efficacy		0.76
I can usually handle whatever comes my way.	0.701
Thanks to my resourcefulness, I know how to handle unforeseen situations.	0.683
I am confident that I could deal efficiently with unexpected events.	0.671
I can remain calm when facing difficulties because I can rely on my coping abilities.	0.653
When I am confronted with a problem, I can usually find several solutions.	0.633
If I am in trouble, I can usually think of a solution	0.622
I can always manage to solve difficult problems if I try hard enough	0.589
It is easy for me to stick to my aims and accomplish my goals.	0.579
I can solve most problems if I invest the necessary effort.	0.490
If someone opposes me, I can find the means and ways to get what I want.	0.419
Psychological Distress		0.88
In the past 4 weeks, about how often did you feel worthless?	0.820
In the past 4 weeks, about how often did you feel depressed?	0.792
In the past 4 weeks, about how often did you feel hopeless?	0.789
In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up?	0.779
In the past 4 weeks, about how often did you feel tired out for no good reason?	0.686
In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down?	0.661
In the past 4 weeks, about how often did you feel so restless you could not sit still?	0.626
In the past 4 weeks, about how often did you feel restless or fidgety?	0.611
In the past 4 weeks, about how often did you feel nervous?	0.574
In the past 4 weeks, about how often did you feel that everything was an effort?	0.460

Table 1 shows the list of dimensions and their factor loadings wherein Factor 1 of Academic Resilience: Perseverance has the largest factor loading (0.852) in terms of academic resilience, which indicated the highest variance and best explains academic resilience among the three dimensions. In terms of Self-efficacy, "I can typically handle whatever comes my way", best reflects the construct of self-efficacy which displayed the highest factor loading (0.701). While "If someone opposes me, I can find the means and ways to get what I want," yielded the lowest load among other indicators (0.419). "In the previous four weeks, roughly how often did you feel worthless?" is the indicator that explains the construct in terms of psychological distress, which has been found to have the largest factor load (0.8420), while the indicator with the lowest factor load appears to be "In the past four weeks, how frequently did you feel like everything was an effort? ” (0.460).

Profile of the Emerging Adults

Table 2 shows the profile of the emerging adults using means and standard deviations in terms of psychological distress, self-efficacy, and overall academic resilience.

Table 2

*Profile of the Emerging Adults*
Variable	Mean	Std. Deviation	Interpretation
Psychological Distress	29.59	8.322	Moderate
Self-Efficacy	29.22	4.729	Moderate
Academic Resilience	114.72	13.40	Moderate
Academic Resilience Factor 1: Perseverance	56.25	6.246	High
Academic Resilience Factor 2: Reflecting and Adaptive Help-Seeking	36.46	4.698	Moderate
Academic Resilience Factor 3: Negative Affect and Emotional Response	22.01	4.988	Moderate

The results of the responses from the Kessler Psychological Distress Scale, scores ranging from 12 to 50, show that the students with a mean of 29.59 indicate borderline moderate and severe psychological distress.

In terms of Self-Efficacy, a higher score indicates high self-efficacy. Results showed that many students with a mean of 29.22 have moderate self-efficacy.

In terms of overall academic resilience, results show that many students with a mean of 114.72 show moderate academic resilience. Looking at the factors of academic resilience separately, it was found that many of the respondents showed high academic resilience in terms of Factor 1 (Perseverance) with a mean of 56.25, Factor 2-Reflecting and Help-Seeking (36.42), and 22.01 mean for Factor 3-Negative Affect and Emotional Response.

Path Analysis

Table 3 shows the path analysis indicating the significant positive effect of self-efficacy on academic resilience, the significant negative effect between self-efficacy to psychological distress; and the significant negative effect between self-efficacy to psychological distress.

Table 3

*Path Analysis*
Dependent Variable	Independent Variable	Unstandardized Estimate		p-value	Decision
Academic Resilience	General Self-Efficacy	4.767	0.47	< 0.001	Significant
Psychological Distress	General Self-Efficacy	-0.459	-0.378	< 0.001	Significant
Academic Resilience	Psychological Distress	-2.299	-0.276	< 0.001	Significant

SEM indicated that self-efficacy has a positive effect on academic resilience (.47, p = 0.001). The alternative hypothesis was accepted with a p-value of the path lower than 0.05. The findings of a study conducted on African-American high-school students revealed that self-efficacy promotes academic success and is an attainable component of resilience, confirm this conclusion ^[25].Similarly, It was also found that students who had high levels of resilience also showed strong self-efficacy and felt more capable of adjusting to challenges in life, particularly in the academic setting^[32]. Thus, self-efficacy may help students adapt to emotional, behavioral, and academic problems. that could lead to better academic resilience. Hence, high self-efficacy leads to better academic

resilience.

SEM indicated a significant effect of self-efficacy on psychological distress (.459, p = 0.001). The alternative hypothesis was accepted because the p-value was lower than 0.05. The same findings were found from the study conducted among African-American high school students in 2017, where high self-efficacy may also help reduce a student’s susceptibility to anxiety and depression^[29]. The self-efficacy theory supports this phenomenon that verbal persuasion techniques and feedback from important persons can be practiced to enhance self-efficacy, explaining that stressful situations can activate psychological disturbances^[20]. Hence, higher self-efficacy leads to lower psychological distress.

Low academic resilience is correlated with severe psychological distress, according to SEM (.28, p = 0.001). This outcome is congruent with research on Pakistani college students who reported substantial psychological distress due to the change in learning style, including anxiety, stress, and despair^[4]. Research on the specific relationship between student psychological distress and resilience is few as of this writing. However, it was observed that students typically use coping mechanisms to deal with adversity on a constant basis. They also exhibit a strong purpose, dedication, and work ethic to succeed^[37] as well as receive support from close family and friends to bounce back quickly from adversity ^[18].

Preliminary Model Test

The preliminary model testing was conducted to test if the structural equation model fits the observed data, and answered the succeeding research questions. The test was a requirement to assess the model's fit indices and a prerequisite to path analysis. Table 4 shows the five standard model fit measures used: ChiSquare (CMIN), Root Mean Square Error of Approximation (RMSEA), Goodness-of-Fit Index (GFI), Normed Fit Index (NFI), and Comparative Fit Index (CFI).

Table 4

*Model Fit Measures*
Measure	Estimate	Threshold	Interpretation
Chi-square (CMIN)	370.425	-	Excellent
Degrees of Freedom (DF)	212	-	Excellent
Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF)	1.747	Between 1 and 3	Excellent
Goodness-of-Fit Index (GFI)	0.918	> 0.90	Excellent
Normed Fit Index (NFI)	0.902	> 0.90	Excellent
Comparative-of-fit Index (CFI)	0.955	> 0.95	Excellent
Standardized Root Mean Square Residual (SRMR)	0.063	< 0.08	Excellent

The measures were based on the cutoff criteria for fit indices in the covariance Structure Analysis introduced by Hu and Bentler in 1999^[14]. The result revealed satisfactory or excellent results, which means that the hypothesized model preliminary tested fits the observed data and indicates that the model was successfully tested to show the causal relationship and path analysis.

Fit statistics criteria included a Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF) estimate of 1.747 with a cut-off threshold between 1 and 3; a Root Mean Square Error of Approximation (RMSEA) of 0.046, less than 0.06 to indicate a good fit; a Goodness-of-Fit Index (GFI) of 0.918 with a cut-off score of > 0.90; a Normed Fit Index (NFI) of 0.902 with a cut-off score of > 0.90; and a Comparative-of fit Index (CFI) of 0.955, with a cut-off criteria of > 0.95 to indicate a good model fit. The results of SEM and those of the causal path testing with estimates of the resulting final model are shown in Fig. 2, with standard path coefficients significant at a p-value of p < .05.

Mediation Analysis

The result of the mediation analysis and its indirect effects are shown in Table 5, indicating that psychological distress is a mediating variable in the causal relationship between self-efficacy and academic resilience. The causal mediation analysis approach (CMA) is a commonly used method that estimates the total effect, direct effect, and indirect effect of the independent variable (Self-Efficacy) on the dependent variable (Academic Resilience) through the mediator (Psychological Distress). The mediation effect was then calculated as the proportion of the total effect (0.104) that was explained by the mediator.

Table 5

Mediation Analysis, Indirect Effects
Indirect Effects	Unstandardized Estimate			Lower	Upper			p-value	Standardized Estimate
GSE → KDPS → ARS_T		1.056	0.678			1.655	0			0.104***

It was found that there was a significant (p-.001) indirect effect of General Self-Efficacy to Academic Resilience (B = 1.056), indicating that Psychological Distress is a mediating variable on the effect of self-efficacy and academic resilience.

Emerging adult college students’ manifestations of psychological distress have continuously risen since the global pandemic began. Looking at Leonard Pearlin's theory on the Stress Process, problems encountered by an individual may continue to arise from life events that may be associated with chronic stressors. A recent study on depressive symptoms among young adults in the Philippines shows that 1 in 10 young adults, which comprises 8.9% of the country's population sample, experience moderate to severe depressive symptoms^[25]. The findings of the study herein provide the first evidence that confirms our hypothesis that (a) high self-efficacy in students leads to better academic resilience. According to Bandura's theory of self-efficacy, an individual’s ability to deal with difficult or stressful situations is influenced by perceived self-efficacy^[5]. A previous finding supports this phenomenon which found that self-efficacy may help students adapt to emotional, behavioral, and academic problems^[25]. Thus, this leads to better academic resilience. This also suggests that improving academic self-efficacy could represent one of many potential intervention strategies for psychological problems that a student may experience whether in school, the community, or at home. To date, the few studies that deal with academic resilience have been focused on basically how to perform better, increase performance, and engage more in extracurricular activities. However, few studies focus on the mediating role of psychological distress experienced by students while maintaining self-efficacy and remaining academically resilient. According to a recent local study where one-fourth were reported to have had moderate-to-severe anxiety, and one-sixth said moderate-to-severe depression, confirming the second hypothesis that (b) students who manifest high psychological distress tend to experience lower academic resilience^[21]. This means that a disturbance in their psychological well-being is a factor to consider for not being able to adapt to a difficult or stressful situation. Thus, students may need to continuously cope with challenges ^[1]. (c) The higher self-efficacy, the lower the psychological distress. This finding was supported by a recent study on adolescents’ mental health, showing that high academic self-efficacy increases scholastic attainment and may also help reduce a student’s susceptibility to psychological distress^[25].

Emerging adult college students experienced moderate to high psychological distress during the COVID-19 pandemic that significantly compromised their overall mental health. As predicted in the hypotheses, the findings of the study showed that high self-efficacy leads to better academic resilience. Secondly, higher self-efficacy leads to lesser psychological distress, suggesting that an improvement in self-efficacy could represent one of many potential intervention strategies for psychological distress.

In terms of psychological distress, results show that most respondents manifest high anxiety and depression levels and are likely to have a moderate-to-severe psychological disorder. Thus, a disturbance in their psychological health due to academic concerns needs to be addressed. This supports the findings that high psychological distress leads to lower academic resilience. The mediation analysis of the variables showed that psychological distress is a mediating variable in the causal relationship between Self-Efficacy and Academic Resilience.

The findings of this study implied that continued support in terms of tailored psychological guidance is necessary to address manifestations of psychological distress in emerging adults, reduce its severity and further improve self-efficacy and academic resilience. The mediation analysis of the variables showed that psychological distress is a mediating variable in the causal relationship between Self-Efficacy and Academic Resilience^[19]. Hence, improving existing counseling programs and developing new ones intended for psychological distress and other factors mentioned above may significantly reduce the stigma associated with professional help-seeking and bridge the treatment gap in psychological disorders. Effectuating new and improved interventions may raise mental health awareness and provide access to professional help.

The present research extended its recommendations to include the implementation of a proposed campus-wide clinical intervention aimed at addressing psychological distress, self-efficacy, and academic resilience.

Table 6 below depicts the proposed individual psychological intervention for emerging adults based on the guidelines of the Substance Abuse and Mental Health Services Administration's (SAMHSA) published work in 2021 for the Prevention and Treatment of Anxiety, Depression, and Suicidal Thoughts and Behaviors Among College Students^[38]. Proposed CBT techniques incorporated were also adapted from A Provider's Guide to Brief Cognitive Behavioral Therapy^[11].

Table 6

*Proposed Individual CBT Intervention*
SESSION	FOCUS	CBT TECHNIQUE USED	PLAN OF ACTION	EXPECTED OUTCOME
1	Assess Student Concern Introduce CBT Model	Essential psychotherapy skills	Identify the students’ presenting problem (i.e., manifestations of psychological distress based on their test results)	Set treatment plan Describe Problem in Context of CB Model
2	Psychological Distress symptoms · feelings of worthlessness · depressed mood · feelings of hopelessness · feelings of sadness that nothing could cheer you up	Cognitive distortions Thought Journaling Progressive muscle relaxation	Identify negative thoughts. Introduce the concept of challenging ‘hot’ thought. Introduce a three-column thought record on unhealthy thought patterns. Practice Progressive muscle relaxation and other relaxation techniques Set homework	Identifying Unhealthy Thoughts / Beliefs Practice three-column with events from the past week. Relaxation and Mindfulness Activity
3	Mood	Review Progressive Muscle relaxation Guided Imagery	Assess progressive muscle relaxation Imagery exercise on unhealthy	Success practice of progressive muscle relaxation and begin Imagery exercise Challenging Unhelpful Thoughts / Beliefs
4	Review challenged thoughts to help maintain Self-Efficacy	Socratic Dialogue on the items of Self-Efficacy: 1. I can usually handle whatever comes my way. 2. Thanks to my resourcefulness, I know how to handle unforeseen situations. 3. I am confident that I could deal efficiently with unexpected events. 4. I can remain calm when facing difficulties because I can rely on my coping abilities	Guide Questions: What would be an example of your ways to handle/solve difficulties that come your way? What are your reasons for saying that? Why did you say that? Could you explain your reasons to us? What led you to that belief? What would you say to someone who has the same thought/experience?	To ask questions that Probe Information, Reasons, Evidence, and Causes, Review challenged thoughts that caused psychological distress Identify ways how to maintain self-efficacy
5	Review challenged thoughts to help maintain Academic Resilience	Socratic Dialogue on the items of Academic Resilience: Perseverance Factor: 1. working harder 2. trying harder 3. accepting feedback to improve work Reflecting and Adaptive Help-Seeking Factor: 1. reflecting on strengths and weaknesses 2. altering approaches to study 3. seeking help 4. support and encouragement 5. monitoring efforts and achievements administering rewards and punishment	Guide Questions: What would be an example of your ways to handle/solve difficulties that come your way? Could you explain your reasons to us? What led you to that belief? What would you say to someone who has the same thought/experience?	To ask questions that Probe Information, Reasons, Evidence, and Causes, Review challenged thoughts that caused psychological distress Identify ways how to maintain academic resilience
6	Review Progress of treatment	Complete sessions	Introduce self-management techniques	Termination of Case

Note

Adapted from Cully et al. (2020) A Provider's Guide to Brief Cognitive Behavioral Therapy.

CBT techniques adapted to the intervention included essential psychotherapy skills, cognitive distortions, thought journaling, progressive muscle relaxation, guided imagery, and Socratic dialogue. This intervention is designed in the context of the CBT Model to identify unhealthy thoughts/beliefs, challenge these thoughts that cause psychological distress, and determine ways to maintain self-efficacy and resilience.

RECOMMENDATIONS

The present study provided an expanded understanding of emerging adults' pressing concerns of having moderate to severe levels of psychological distress while maintaining self-efficacy and academic resilience. However, there are potential limitations of this study to be considered by future researchers. It is important to recognize that the data gathered were from the screening tools to measure psychological distress, self-efficacy, and academic resilience during a radical transition from one learning setup to another. Therefore, additional qualitative data can substantiate the focus on examining the variables and eventually uncover the extent to which the factors are associated with the student's overall mental health.

In the context of COVID-19, the present study's findings were still beneficial even after the pandemic. Hence, testing the efficacy of the proposed CBT intervention may help emerging adults deal with adverse situations, alleviate psychological distress, and increase health-promoting behaviors.

Conflict of Interest

We hereby declare that there are no existing relations between the authors and the subjects or entities discussed in the study, as well as any conflict of interest.

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No competing interests reported.

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The Mediating Role of Psychological Distress on the Effect of Self-Efficacy to Academic Resilience of Emerging Adults: Implications for CBT Intervention

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Abstract

Figures

INTRODUCTION

Research Impediments

Significance of the Study

THEORETICAL FRAMEWORK

The Stress Process

Self-Efficacy Theory

The Challenge Model of Resilience

The Hypothesized Model

METHODOLOGY

Subject and Study Sites

Research Instruments

Data Gathering Procedure

Ethical Consideration

Data Availability Statement

Data Analysis

RESULTS AND DISCUSSION

Profile of the Emerging Adults

Path Analysis

Preliminary Model Test

Mediation Analysis

Discussion

CONCLUSION

RECOMMENDATIONS

Declarations

Conflict of Interest

References

Additional Declarations

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